Provider Demographics
NPI:1235705583
Name:POLLARD, ASHLEY RENAE (LPCC)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:RENAE
Last Name:POLLARD
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:680 STEWART AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55102-4117
Mailing Address - Country:US
Mailing Address - Phone:651-292-2404
Mailing Address - Fax:
Practice Address - Street 1:680 STEWART AVE
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55102-4117
Practice Address - Country:US
Practice Address - Phone:651-292-2404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-27
Last Update Date:2021-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2826101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty